Hem/Onc

Question 1

How to differentiate between alpha and beta thalassemia

Answer 1

Electrophoresis, beta thalassemia will have increased hemoglobin A2

Question 2

Dx and Management of HIT

Answer 2

Dx: clinical, definitive test is serotonin release assay
Stop all heparin products
Transition to argatroban or fondaparinux
Start warfarin when platelet count >150,000 and after treatment with another anticoagulant

Question 3

Findings on EGD of patient with pernicious anemia

Answer 3

Atrophy in the gastric fundus and body (absent rugae)

Question 4

TTP

Answer 4

Due to acquired antibodies against ADAMTS13

Needs plasma exchange to antibodies and replenish ADAMTS13 levels from donor

Question 5

CML

Answer 5

Translocation of chromosomes 9 and 22, creates a bcr-abl fusion protein that leads to unregulated stimulation of the tyrosine kinase system
Tx w/ tyrosine kinase inhibitor

Question 6

Tx for prolonged bleeding time in patients with renal dysfunction

Answer 6

IV desmopressin, works be releasing factor VIII:von Willebrand factor multimers from endothelium

Question 7

Best treatment for methotrexate induced macrocytic anemia

Answer 7

Folinic acid (leucovorin) rather than folic acid

Question 8

Vitamin K reversal

Answer 8

Prothrombin complex concentrate (acts within 10min) and vitamin K (takes 12-24h)

Question 9

Tx of ITP

Answer 9

mild or no bleeding:observe

bleeding: IVIG